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There’s a new study out that shows what I have known and has already been proven in my life already. And that is psychotherapy or, more specifically, cognitive behavioral therapy helps people with ADHD improve and cope.
The study was conducted by: Steven A. Safren, PhD, ABPP; Susan Sprich, PhD; Matthew J. Mimiaga, ScD, MPH; Craig Surman, MD; Laura Knouse, PhD; Meghan Groves; Michael W. Otto, PhD and is published in Journal of the American Medical Assn. Author Affiliations: Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Safren, Sprich, Mimiaga, Surman, Knouse, and Otto and Ms Groves); Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Drs Safren, Sprich, Mimiaga, Surman, and Knouse); and Department of Psychology, Boston University, Boston, Massachusetts (Dr Otto).
I was absolutely delighted when I received this new study today. If you have read my book One Boy’s Struggle: A memoir – Surviving Life with Undiagnosed ADD, you know then that psychotherapy was a major life changing experience for me. No other treatment has been as effective for me as my therapy sessions with Dr. Gary. I went from the brink of depression and hopelessness to living a more positive, fulfilling life. It’s difficult to describe in a short article how profound the change was for me, but I described it in detail in my book for you as a therapeutic effort no less suggested by my therapist.
Unfortunately, I cannot take medication for my ADHD, sometimes I wish I could, but due to a past severe reaction to an SSRI it is very difficult for me to take any type of stimulant. However, if I could take medication, no matter how effective, it would not be able to teach me skills or give me better insight into who I am, the way I think and why / how I do things. Cognitive behavioral therapy does that and in my opinion anyone who suffers from the raw symptoms of ADHD would benefit. Especially, people like me later diagnosed and have already suffered life-long extreme consequences.
Whether we realize it or not, ADHD pretty much encompasses everything we do behaviorally, it is so much more than just a label and therefore, when we think negative of ADHD, we tend to think negative and depressing thoughts about ourselves. At least, that is what I have learned through therapy. I learned that I can be for me and not against me and I have learned valuable skills via therapy that allow me to thrive with ADHD. I don’t always win when working with my ADHD symptoms; however, when I don’t, I realize that a setback isn’t the end of the world. I do not spiral out of control into self-defeating thoughts recounting every defeat as though I am in a battle against an overwhelming enemy. Because, really, the enemy isn’t a label we have defined (as we may tend to believe), it is ourselves we are punishing, ridiculing and chastising. Such punishment can be far worse than any external punishment from anyone else.
If we receive therapy from a good therapist we can learn that no matter what our condition or disorder, how we think of it has a profound effect on our lives as a whole, how we improve and, as I mentioned, how we truly think of ourselves looking into the mental mirror consciously and subconsciously.
Here’s an example of my belief, before therapy helped me realize my perspective:
My behavior (ADHD) is a curse = I am a curse, life is a curse, everything is a disaster and therefore, I will always suffer and utterly fail. There’s nothing positive about my behavior (ADHD) and, of course, nothing positive about me.
How can one improve, or succeed for that matter, with that type of thinking and belief system? I even went out of my way to prove those things to myself, as we always seek to prove or justify what we think and believe whether it is negative or positive, it’s a natural phenomenon.
We only have one life to live and we are here to try to make the best of it. Positive ways of thinking and coping skills (time management, organization, completing tasks etc) learned through personalized professional therapy can help us do that. There’s no doubt untreated ADHD has devastating consequences and treated ADHD can still be extremely difficult, but what we think and how we think of it is far more profound than many of us may realize.
I truly believe we all deserve more credit than we actually give ourselves. Therapy taught me that. For those who can take ADHD medication, I realize it can possibly change your whole world to a better place and when one adds professional, competent therapy to the mix it can round out the treatment process to make life even more enjoyable and fulfilling. Of course, I am speaking only my opinion and experience here. I can’t give you medical advice, so please visit with a qualified therapist if you want to find out how therapy may help you personally.
Finally, a positive news headline from the Las Angeles Times:
Focused talk therapy helps adults with ADHD
~Bryan
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Hi Bryan,
Yes, therapy can help people with ADHD, even if the ADHD hasn’t been recognized yet. As long as the therapy doesn’t misattribute ADHD symptoms as “psychological behaviors” and overly focus on those.
I imagine there are many people with late-diagnosis whose previous therapy kept them back from the brink, especially if it helped to counter many of the counter-productive coping strategies that can develop over a lifetime of not knowing one has ADHD.
But it’s important to note that these studies on CBT for ADHD come with important details. Excerpted from the Medcape report on this study:
A previous pilot study of CBT by Dr. Safren and colleagues in this patient population showed those taking medication who received CBT had greater symptom reduction compared with those taking medication alone (Behav Res Ther. 2005;43:831-842).
On the basis of these positive results, the team launched the current efficacy study, which included 86 symptomatic adults who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for ADHD and who were already treated with medication in the community setting but were still reporting clinically significant symptoms.
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Note that this study does not compare CBT to medication, but that these subjects were already being treated medically.
The comparison was between CBT and relaxation therapy. The study showed that informed, ADHD-savvy CBT was better than relaxation exercises. (To anyone who has led an adult support group, as I have, this falls into the category of DUH. But even obvious things must be proven; that’s how science works.)
It’s also vital to stress that this type of CBT is specifically focused to ADHD, acknowledging its neurogenetic underpinnings. That MUST be part of the equation.
“Straight” CBT that not grounded in knowledge of ADHD can potentially increase a person’s distress, as they might conclude that their continued challenges in life is due to “negative thinking” rather than real neurobiological issues.
Psychologist Russ Ramsay has also conducted studies on ADHD-focused CBT therapy. He writes about its components here:
Reply to Gina Perahttp://tinyurl.com/2bs4kjz
Bryan,
Reply to ChristineIt is SO true. ADHD does encompass everything we do behaviorally. It has become that unconcious obstacle in my life.
Medication is helpful, but learning how to live with your “deficits” and turn them in to “assetts” is very necessary. As a newly diagnosed adult, I am beginning to recognize that negative spiral of thoughts.
We have to learn an entire new way of thinking. It is amazing how much thoughts can cause so much unhappiness.
I think it is a journey of learning and changing…not a bad thing at all!
Yes, indeed, Christine “thoughts are things” we have to find ways to make them work for us and not against us. Therapy helps.
Reply to Bryan HutchinsonBryan, I was just thinking about this yesterday, coincidentally. Then I remembered something that I had truly forgotten> When I was about 12 or 13, my Mom took me to a Psychiatrist, in hopes that I might stop being so rebellious or mad at the world or whatever she thought was screwing me up(it’s hard to explain).
ADHD wasn’t even talked about or considered back in those days. She probably didn’t even know what the letters ADHD stood for. It just wasn’t in the news,etc…back then. Well I went once and didn’t ever go again. I just thought it was for crazy ppl, and that’s what I told Mom later. Now recently this kind of therapy has been strongly recommended for me via of NeuroPsych Evaluation….3 1/2 yrs ago (lol).
I may try it now, but I just thought it was interesting that this (your post) came at this time. Thanks Bro.!
Reply to Scott HutsonScott.
That’s funny Scott (sort of) because when I was younger, like you were, I thought therapy was for crazy people too… but then, what’s really crazy anyway??!! lol
Reply to Bryan HutchinsonI personally had years of very effective talk therapy sessions from my late teens through adulthood. Cognitive Behavioral Therapy literally saved my life in many ways. However, this NEED for help was never attributed to having ADD, as that was an unheard of diagnosis at the time. I was given other diagnosis, all of which were misdirected. But CBT is a lifesaver for ADHD and ADD patients, especially those with impulsive speech issues. I was driven to talk about my feelings, burning bridges in normal friendships for decades before getting my diagnosis in my late 40s.
If only I had been diagnosed properly years earlier, I would have finally known the answer to the eternal questions those of us who are challenged with these issues ask. “What is wrong with me? Why do I screw up everything?”
Instead, at least CBT taught me the self-monitoring techniques I so desperately needed and gave me tools to cope with my anxiety about being so “different” in social circles. Self-monitoring of any kind begins with realizing you have issues… and that you can control how you react to your environment, livig a PRO-active instead of RE-active life
I’m glad now CBT is being recognized to be the effective therapy it is for ADD and ADHD patients. I personally believe it is a keystone therapy for Adult ADD and ADHD patients.
Reply to R. R. Murdock, MAEdTherapy helped me long before my ADHD diagnosis years later. I think CBT is extremely effective, but have also noticed from reading up on this topic, for some with ADHD and extreme comorbids, comorbids which help create anger, extreme anxiety and pessimism etc or extreme mood swings, CBT isn’t unproblematic because it is very difficult to find trust and allow one’s self to be treated this way. However, more importantly and this is vital, not all therapists are created equal. It took me several visits to several therapists before I found one that I felt comfortable with. As Gina mentions above, once ADHD is diagnosed it is important that the therapist consider ADHD behaviors for what they are and treat them accordingly, along with whatever ramifications they have had so far in one’s life.
Reply to Bryan HutchinsonBut CBT works like Gina Pera said for medicated. I’ve known about CBT and other positive thinking type techniques for years but it wasn’t until I got medicated for ADHD that it started to work and mostly on my anxiety.
Reply to AnnAnn, I think medication can help increase the speed of the treatment, possibly. I have never been able to successfully take medication for my ADHD or Depression; therefore, it also helps the unmedicated, like me. I think part of the issue is the CBT can sometimes take several months to several years to really make a difference. When medication works people see a difference quite quickly. I tend to think many give up on CBT within a year because it just takes too long and the positive results sometimes do not truly present themselves for years. In many ways I think I have been blessed that I could not take medication and had to keep on with the therapy because I do feel so much better about myself and my improvements over the years have been sometimes slow, but dramatic and since they are not maintained by medication I tend to think they have a greater chance of lasting as major internal conflicts have been resolved through the therapy.
Reply to Bryan Hutchinson